Insurance Program Supervisor

2 days ago

Fall River, Massachusetts, United States Steward Health Care Full time
Job Title: Insurance Program Supervisor

Steward Health Care is seeking an experienced Insurance Program Supervisor to oversee all aspects of the Insurance Program Specialist objections and ensure the daily oversight and reconciliation of all self-pay patients.

Key Responsibilities:
  • Coordinate and oversee training of all new staff on required competencies, including providing education and preparing new staff for the Massachusetts and Rhode Island state required Certified Application Counselor exams
  • Ensure all training manuals and training curricula are up to date and readily accessible
  • Coordinate schedule of staff and assists director in covering unexpected absences to ensure staffing compliment meets demands of department
  • Assists director with coordination of scheduled vacations
  • Orients and trains staff on all hospital operating systems including: Meditech; Revenue Protect; MA Health Connector via Optum; Virtual Gateway; Health Source of RI; various payer eligibility tools
  • Responsible for the ordering of supplies from bulk stores and online Steward approved vendors and ensuring the department always has an adequate supply of items needed
  • Coordinates the transfer of confidential documents including PHI (Personal Health Information) to Steward approved vendor to storage for required seven years
  • Responsible for the daily oversight and reconciliation of all self pay patients, ensuring all have been seen and counseled on their eligibility for and availability of health insurance plans
  • Works closely with and effectively communicates to internal and external customers (e.g., patient access, case management, social work, physician offices, insurance carriers, state Medicaid offices) to ensure alignment and customer satisfaction
  • Works closely with staff and director to facilitate a team environment where collaboration is fostered
  • Screens all self pay patients, identifies solution(s) and facilitates patient payment and/or solution application process (manual and/or electronic)
  • Collects and verifies patient demographic, insurance eligibility, and financial information/responsibility and accurately documents in hospital computer system(s)
  • Follows up and obtains all documentation required for application processing and accurately enters information into hospital and external systems as appropriate
  • Identifies via workflow technology current and prior patient responsible balances, educates patients on their financial responsibilities, and collects same
  • Assists patients in establishing secured installments plans when applicable
  • Interviews patients bedside as needed to facilitate timely and effective payments and/or complete insurance solution application process
  • Monitors, manages and actively follows up on active self pay accounts to ensure solutions / solution modifications in place for patients and optimize ultimate payment for the hospital
  • Establishes schedule for "walk-in" insurance assistance applicants and facilitates application process for same
  • Fields patient billing inquiries and refers to appropriate PFS staff for resolution
  • Responsible for consistent and accurate use and execution department procedures and protocols and supporting tools, software, websites
  • Meets performance standards established by Patient Access leadership, including but not limited to: quality, collections, customer service, screening/solution rates and productivity
  • Keeps current with all internal and external policy and procedures that may affect reimbursement
  • Delivers exemplary customer service for patients in accordance with hospital expectations / guidelines
  • Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment
  • Commits to recognize cultural diversity and communicate effectively with internal and external customers with respect of differences in culture, values, beliefs and ages
  • Performs all other duties as assigned
Requirements:
  • Maintains detailed knowledge of private, public and third-party payer insurance and related regulations
  • Familiarity with Massachusetts Medicaid eligibility requirements, and a detailed knowledge of navigation of insurance application process
  • Knowledge to educate others on state and federally offered insurance programs
  • Detailed knowledge of medical terminology
  • Outstanding communication and interpersonal in a customer service-based health care setting
  • Ability to work with a high degree of confidentiality
  • Familiarity with Meditech preferred
  • Detailed knowledge of Microsoft Office tools
  • Comprehensive knowledge of tools, systems, and technologies to enable insurance verification and facilitate insurance solutions
  • Experience with securing solutions for uninsured patients
  • Detailed knowledge of health insurance and reimbursement/billing required
  • Ability to problem solve and follow through under ambiguous circumstances
  • Ability to show empathy and encouragement to patients and their family members

Bilingual in Portuguese preferred

Additional Information

Steward Health Care is an Equal Opportunity Employer

We are committed to diversity and inclusion in the workplace

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